Liability of Urgent Care Providers
Yes, urgent care providers can absolutely be held liable for medical malpractice if their care deviates from the applicable standard of care and causes patient harm, regardless of the complexity of the presentation. 1
Legal Framework for Liability
Urgent care providers face the same malpractice exposure as any other physician, with liability established through four required elements 1:
- Duty to the patient - established by the physician-patient relationship that begins when the urgent care provider accepts the patient for evaluation 1
- Breach of the standard of care - the provider's actions must fall below what "reasonably prudent" physicians in similar circumstances would do 1
- Causation - the breach must be the proximate cause of the patient's injury 1
- Damages - actual harm must result, whether sequelae, death, or other injury 2
Standard of Care in Urgent Care Settings
Urgent care providers are held to the standard of "reasonable and ordinary care, skill, and diligence" that physicians in good standing and in the same general line of practice ordinarily exercise in similar circumstances. 1
Key Considerations:
- The standard is increasingly national rather than local, particularly for board-certified physicians, though some jurisdictions still apply a "locality" standard that accounts for resource limitations in rural or underserved areas 1
- A bad outcome alone does not prove negligence - negative outcomes can occur even with proper treatment 1
- Negligence cannot be inferred solely from failure to cure, unexpected results, or lack of success 1
Critical Pitfall: Complex Presentations
For a patient presenting with tooth abscess, GI symptoms, and night sweats:
The urgent care provider must recognize when a presentation exceeds their scope or requires specialized evaluation, and failure to appropriately refer or escalate care can constitute a breach of the standard of care. 1
Specific Liability Risks:
- Dental abscesses can cause life-threatening complications including sepsis and distant organ involvement through hematogenous spread 3, 4
- Night sweats combined with dental infection suggest possible systemic spread or severe infection requiring urgent evaluation 3
- Missing red flag symptoms such as difficulty swallowing, drooling, neck tenderness, or severe odynophagia that indicate deep space infection or impending airway compromise 5
- Failure to recognize that periodontal abscesses are the third most frequent dental emergency and can rapidly destroy tissue 6
Burden of Proof
The plaintiff must prove all elements by a preponderance of evidence (more than 50% likely), not beyond reasonable doubt 1. This is a relatively low bar compared to criminal cases.
Expert Witness Role:
- Expert witnesses establish the applicable standard of care and whether deviation occurred 1
- Out-of-state experts may need to demonstrate familiarity with local standards in some jurisdictions 1
Practical Risk Mitigation
Document thoroughly that you:
- Recognized the complexity of the presentation 1
- Considered serious complications (sepsis, deep space infection, systemic spread) 3, 4
- Made appropriate referrals to emergency department or specialists when indicated 5
- Provided clear discharge instructions about red flag symptoms requiring immediate return 5
The majority of malpractice claims (approximately 64%) are ultimately dismissed, but this does not eliminate the risk, stress, and cost of defending against claims. 2
When Urgent Care Setting Is Insufficient
Patients with severe odynophagia, drooling, neck swelling/tenderness, or systemic symptoms (fever with night sweats) require immediate emergency department evaluation, not urgent care management. 5 Failure to recognize this and attempting to manage beyond your scope constitutes a breach of the standard of care. 1